COPD

Question 1

What are signs of bronchitis?

Answer 1

Cough
Dyspnea
Right heart failure
Normal percussion
Wheeze, Rhonchi
Overweight
Normal AP
>35 years old
Central cyanosis

Question 2

What are signs of emphysema?

Answer 2

Thin
Dyspnea
No sputum
Hyperesonant
Decreased breath sounds
>50 years old
Increases AP
Pursed lip breathing
Tripod breathing

Question 3

What diagnostics would you do to diagnose COPD

Answer 3

CXR
PFT
ABG
Alpha 1 antitripsin deficiency
Bronchodilator (if no improvement then COPD)

Question 4

Mild COPD (FEV1 FVC 80%) should be given what medication(s)

Answer 4

SABA-

Albuterol or if cardiovascular problems then Xopenex

Question 5

Group B COPD (FEV1 FVC 50-79%)

Answer 5

SABA and a LABA with anticholinergic (Spiriva)

Question 6

Group C COPD (FEV1 FVC 30-50%)

Answer 6

SABA, LABA and steroid (symbicort or advair)

Question 7

Group D COPD (FEV1 FVC

Answer 7

All of the above and maybe long term O2

Question 8

What is the goal for oxygen in stage 4 COPD?

Answer 8

Initiate at a PaO2 of 55 or a sat of 88%

Goal is PaO2 of 60 and O2 sat of 90%

Question 9

Treatment for COPD exacerbation is what?

Answer 9

Oxygen to maintain O2
Nebulizer treatments (atrovent/albuterol)
Steroids (prednisone 30-40mg for 10-14 days)
ABX (maybe)

Question 10

When do you initiate ABX on a COPD exacerbation patient?

Answer 10

If they have 2/3 of the following:

1. Dyspnea
2. Increased sputum volume
3. Sputum purulence

Or if patient is ventilated

Question 11

If a COPD patient has AMS what can you do to help them?

Answer 11

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